Impaired Energy Expenditure Despite Normal Cardiovascular Capacity in Children with Type 1 DiabetesFintini D.a · Di Giacinto B.e · Brufani C.b · Cafiero G.a · Patera P.I.c · Turchetta A.a · Giordano U.a · Nobili V.d · Pelliccia A.e · Calzolari A.a · Cappa M.c
aCardiorespiratory and Sport Medicine Unit, bScientific Directorate, cEndocrinology and Diabetes Unit, dHepatology Unit of ‘Bambino Gesù’ Children’s Hospital, IRCCS, and eInstitute of Sport Medicine and Science, Rome, Italy
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Article / Publication Details
Background: Benefit of fitness on children with type 1 diabetes mellitus (T1DM) is still debated. Aim: To evaluate the influence of physical activity on metabolic balance and exercise tolerance in prepubertal children affected by T1DM. Methods: We analyzed 35 pre-/peripubertal T1DM children and 31 matched controls using an activity monitor (SenseWear Armbad) and physical activity questionnaire (PAQ) to assess energy expenditure (EE), total and active, sedentary and physical activities (h/day and Mets = metabolic equivalents). The maximal cardiopulmonary exercise test (CPET) was also performed. Results: Total physical activities and total and active EE (>3 Mets) resulted higher in controls than in T1DM patients and self-reported perception of physical and sedentary activities was altered in T1DM children as well in controls and were different from the measured data. No differences were found in CPET parameters with the exception of a higher maximal blood pressure in T1DM children. In multivariate analysis HbA1c negatively correlated with VO2. Conclusion: Prepubertal T1DM children seem to have a lower level of physical activity and EE and a probable altered feeling of physical and sedentary activities. On the other hand, T1DM children do not show any alteration of cardiovascular performance, although glycemic control (HbA1c) may play a role in cardiovascular performance.
© 2012 S. Karger AG, Basel
- Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G, EURODIAB Study Group: Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–2020: a multicentre prospective registration study. Lancet 2009;373:2027–2033.
- Valerio G, Spagnuolo M, Lombardi F, Spadaro R, Siano M, Franzese A: Physical activity and sports partecipations in children and adolescents with type 1 diabetes mellitus. Nutr Metab Cardiovasc Dis 2007;17:376–382.
- Robertson K, Adolfsson P, Scheiner G, Hanas R, Riddell MC: Exercise in children and adolescents with diabetes. Pediatr Diab 2009;10(suppl 12):154–168.
- Younk L, Tate D, Davis SN: Physical activity in adolescents with type 1 diabetes: is more better for glycemic control? Pediatr Diab 2009;10:231–233.
Giannini C, Mohn A, Chiarelli F: Physical exercise and diabetes during childhood. Acta Biomed 2006;77(suppl 1):18–25.
- Nadeau KJ, Regensteiner JG, Bauer TA, Brown MS, Dorosz JL, Hull A, Zeitler P, Draznin B, Reusch JE: Insulin resistance in adolescents with type 1 diabetes and its relationship to cardiovascular function. J Clin Endocrinol Metab 2010;95:513–521.
- Aman J, Skinner TC, de Beaufort CE, Swift PG, Aanstoot HJ, Cameron F, Hvidoere Study Group on Childhood Diabetes: Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere Study Group on Childhood Diabetes. Pediatr Diabetes 2009;10:234–239.
- Corder K, Ekelund U, Steele RM, Wareham NJ, Brage S: Assessment of physical activity in youth. J Appl Physiol 2008;105:977–987.
- Dorminy CA, Choi L, Akohoue SA, Chen KY, Buchowski MS: Validity of a multisensor armband in estimating 24-h energy expenditure in children. Med Sci Sports Exerc 2008;40:699–706.
- Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–1243.
Tanner JM: Growth at Adolescence, ed 2. Oxford, Blackwell Scientific Publications, 1962.
- Fruin ML, Rankin JW: Validity of a multi-sensor armband inestimating rest and exercise energy expenditure. Med Sci Sports Exerc 2004;36:1063–1039.
- Dwyer TJ, Alison JA, McKeough ZJ, Elkins MR, Bye PT: Evaluation of the SenseWear activity monitor during exercise in cystic fibrosis and in health. Respir Med 2009;103:1511–1517.
- Mafra D, Deleaval P, Teta D, et al: New measurements of energy expenditure and physical activity in chronic kidney disease. J Ren Nutr 2009;19:16–19.
Mignault D, St-Onge M, Karelis AD, Allison DB, Rabasa-Lhoret R: Evaluation of the Portable HealthWear Armband: a device to measure total daily energy expenditure in free-living type 2 diabetic individuals. Diabetes Care 2005;28:225–227.
Bäcklund C, Sundelin G, Larsson C: Validity of an armband measuring energy expenditure in overweight and obese children. Med Sci Sports Exerc 2010;42:1154–1161.
- Calabró MA, Welk GJ, Eisenmann JC: Validation of the SenseWear Pro Armband algorithms in children. Med Sci Sports Exerc 2009;41:1714–1720.
- Cumming GR, Everatt D, Hjastman L: Bruce treadmill test in children: normal values in a clinical population. Am J Cardiol 1978;41:69–75.
- American Thoracic Society, American College of Chest Physicians, ATS/ACCP: Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003;167:211–277.
Calzolari A, Turchetta A, Ventre S: Exercise testing on treadmill in normal children. Int J Sport Cardiol 1994;3:27–34.
Bar-Or O, Rowland TW: Pediatric Exercise Medicine. From Physiologic Principles to Healthcare Application. Champaign, Human Kinetics, 2004.
- Laing SP, Swerdlow AJ, Slater SD, Burden AC, Morris A, Waugh NR, Gatling W, Bingley PJ, Patterson CC: Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes. Diabetologia 2003;46:760–765.
- Baldi JC, Cassuto NA, Foxx-Lupo WT, Wheatley CM, Snyder EM: Glycemic status affects cardiopulmonary exercise response in athletes with type I diabetes. Med Sci Sports Exerc 2010;42:1454–1459.
- Diabetes Control and Complications Trial Research Group: Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr 1994;125:177–188.
- Nadeau KJ, Reusch JE: Cardiovascular function/dysfunction in adolescents with type 1 diabetes. Curr Diab Rep 2011;11:185–192.
- Kane I, Robertson RJ, Fertman CI, et al: Predicted and actual exercise discomfort in middle school children. Med Sci Sports Exerc 2010;42:1013–1021.
- Poulton R, Trevena J, Reeder AI, Richard R: Physical health correlates of overprediction of physical discomfort during exercise. Behav Res Ther 2002;40:401–414.
- Hayes C, Kriska A: Role of physical activity in diabetes management and prevention. J Am Diet Assoc 2008;108(4 suppl 1):S19–S23.
- Rowland TW, Martha PM Jr, Reiter EO, Cunningham LN: The influence of diabetes mellitus on cardiovascular function in children and adolescents. Int J Sports Med 1992;13:431–435.
- Kimball TR, Daniels SR, Khoury PR, Magnotti RA, Turner AM, Dolan LM: Cardiovascular status in young patients with insulin-dependent diabetes mellitus. Circulation 1994;90:357–361.
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